HANS P PETERSON MEMORIAL HOSPITAL - CAH (Philip, SD) prices

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
RX-169251	OCRELIZUMAB 30 MG/ML INTRAVENOUS SOLUTION\|DISCARDED DRUG NOT ADMINISTERED	$61,510	$61,510	—	—	8
RX-110751	LEUPROLIDE (LUPRON) 45 MG INTRAMUSCULAR SYRINGE KIT (6 MONTH)\|DISCARDED DRUG NOT ADMINISTERED	$38,376	$38,376	—	—	8
RX-126219	VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION\|DISCARDED DRUG NOT ADMINISTERED	$30,124	$30,124	—	—	8
RX-87861	LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRINGE\|DISCARDED DRUG NOT ADMINISTERED	$29,633	$29,633	—	—	8
RX-4089002	ALTEPLASE 100 MG/100ML IV (WET SOLR VIAL)\|DISCARDED DRUG NOT ADMINISTERED	$26,225	$26,225	—	—	8
RX-9002	ALTEPLASE 100 MG INTRAVENOUS SOLUTION\|DISCARDED DRUG NOT ADMINISTERED	$26,225	$26,225	—	—	8
RX-21108	LEUPROLIDE 30 MG (LUPRON) INTRAMUSCULAR SYRINGE KIT (4 MONTH)\|DISCARDED DRUG NOT ADMINISTERED	$25,584	$25,584	—	—	8
RX-173231	TENECTEPLASE 50 MG INTRAVENOUS SOLUTION - MI\|DISCARDED DRUG NOT ADMINISTERED	$24,726	$24,726	—	—	8
RX-4080030162	TENECTEPLASE 50 MG INTRAVENOUS SOLUTION - STROKE\|DISCARDED DRUG NOT ADMINISTERED	$24,726	$24,726	—	—	8
RX-4080030203	TENECTEPLASE 50 MG INTRAVENOUS SOLUTION - MASSIVE PE\|DISCARDED DRUG NOT ADMINISTERED	$24,726	$24,726	—	—	8
RX-131678	OCTREOTIDE,MICROSPHERES ER 30 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE\|DISCARDED DRUG NOT ADMINISTERE	$20,599	$20,599	—	—	8
RX-129657	PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE\|DISCARDED DRUG NOT ADMINISTERED	$19,126	$19,126	—	—	8
RX-91495	CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) LYPHOLIZED POWDER\|DISCARDED DRUG NOT ADMINISTERED	$17,878	$17,878	—	—	8
RX-172152	BENRALIZUMAB 30 MG/ML SUBCUTANEOUS SYRINGE\|DISCARDED DRUG NOT ADMINISTERED	$17,424	$17,424	—	—	8
RX-40893567	ROMIPLOSTIM 500 MCG/ML SC (WET SOLR VIAL)\|DISCARDED DRUG NOT ADMINISTERED	$16,408	$16,408	—	—	8
RX-185265	TEZEPELUMAB-EKKO 210 MG/1.91 ML (110 MG/ML) SUBCUTANEOUS SYRINGE\|DISCARDED DRUG NOT ADMINISTERED	$13,020	$13,020	—	—	8
RX-133919	MEPOLIZUMAB 100 MG SUBCUTANEOUS SOLUTION\|DISCARDED DRUG NOT ADMINISTERED	$10,951	$10,951	—	—	8
RX-408133919	MEPOLIZUMAB 100 MG/ML SC (WET SOLR VIAL)\|DISCARDED DRUG NOT ADMINISTERED	$10,951	$10,951	—	—	8
RX-185083	INCLISIRAN 284 MG/1.5 ML SUBCUTANEOUS SYRINGE\|DISCARDED DRUG NOT ADMINISTERED	$10,691	$10,691	—	—	8
RX-106804	DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION\|DISCARDED DRUG NOT ADMINISTERED	$10,280	$10,280	—	—	8
RX-197838	DENOSUMAB-BMWO 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION\|DISCARDED DRUG NOT ADMINISTERED	$9,766	$9,766	—	—	8
RX-197484	DENOSUMAB-BBDZ 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION\|DISCARDED DRUG NOT ADMINISTERED	$9,561	$9,561	—	—	8
RX-190785	PROTHROMBIN COMPLEX CONC (PCC) HUMAN-LANS 1,000 UNIT IV SOLUTION (BALFAXAR)	$9,412	$9,412	—	—	8
RX-4080030029	IMMUNE GLOBULIN (GAMUNEX-C, GAMMAKED) 10% INJECTION SOLUTION WRAPPER\|DISCARDED DRUG NOT ADMINISTERED	$9,131	$9,131	—	—	8
RX-40893566	ROMIPLOSTIM 250 MCG/0.5ML SC (WET SOLR VIAL)\|DISCARDED DRUG NOT ADMINISTERED	$8,204	$8,204	—	—	8
RX-40801	LEUPROLIDE 45 MG (ELIGARD) SUBCUTANEOUS SYRINGE (6 MONTH)\|DISCARDED DRUG NOT ADMINISTERED	$8,076	$8,076	—	—	8
RX-176681	ROMOSOZUMAB-AQQG 210 MG/2.34 ML(105 MG/1.17 ML X2)SUBCUTANEOUS SYRINGE\|DISCARDED DRUG NOT ADMINISTER	$7,834	$7,834	—	—	8
PX-3527417400	CT Angio Abd&Plvis Cntrst Mtrl W/WO Cntrst Img	$7,673	$7,673	—	—	8
RX-175906	PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRINGE	$7,599	$7,599	—	—	8
PX-3527417800	CT Abdomen & Pelvis W/O Contrst Followed by W Contrst 1/> Body Re	$7,370	$7,370	—	—	8
RX-129781	DARBEPOETIN ALFA 300 MCG/0.6 ML IN POLYSORBATE INJECTION SYRINGE\|DISCARDED DRUG NOT ADMINISTERED	$6,920	$6,920	—	—	8
PX-3527417700	CT Abdomen & Pelvis W/Contrast Material	$6,590	$6,590	—	—	8
RX-130740	LEUPROLIDE 7.5 MG (LUPRON) INTRAMUSCULAR SYRINGE KIT\|DISCARDED DRUG NOT ADMINISTERED	$6,396	$6,396	—	—	8
RX-179532	EPTINEZUMAB-JJMR 100 MG/ML INTRAVENOUS SOLUTION\|DISCARDED DRUG NOT ADMINISTERED	$5,781	$5,781	—	—	8
PX-3507563500	Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp	$5,779	$5,779	—	—	8
RX-105502	DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRINGE\|DISCARDED DRUG NOT ADMINISTERED	$5,589	$5,589	—	—	8
RX-197842	DENOSUMAB-BNHT 60 MG/ML SUBCUTANEOUS SYRINGE\|DISCARDED DRUG NOT ADMINISTERED	$5,421	$5,421	—	—	8
RX-35236	LEUPROLIDE 30 MG (ELIGARD) SUBCUTANEOUS SYRINGE (4 MONTH)\|DISCARDED DRUG NOT ADMINISTERED	$5,384	$5,384	—	—	8
RX-197833	DENOSUMAB-BMWO 60 MG/ML SUBCUTANEOUS SYRINGE\|DISCARDED DRUG NOT ADMINISTERED	$5,309	$5,309	—	—	8
PX-3527417600	CT Abdomen & Pelvis W/O Contrast Material	$5,009	$5,009	—	—	8
PX-3527417500	CT Angiography Abdomen W/Contrast/Noncontrast	$4,878	$4,878	—	—	8
RX-197483	DENOSUMAB-BBDZ 60 MG/ML SUBCUTANEOUS SYRINGE\|DISCARDED DRUG NOT ADMINISTERED	$4,780	$4,780	—	—	8
PX-3527127500	CT Angiography Chest W/Contrast/Noncontrast	$4,778	$4,778	—	—	8
PX-3527417000	CT Abdomen W/O & W/Contrast Material	$4,644	$4,644	—	—	8
RX-129780	DARBEPOETIN ALFA 200 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE\|DISCARDED DRUG NOT ADMINISTERED	$4,613	$4,613	—	—	8
RX-122648	FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION\|DISCARDED DRUG NOT ADMINISTERED	$4,608	$4,608	—	—	8
PX-3527219100	CT Angiography Pelvis W/Contrast/Noncontrast	$4,452	$4,452	—	—	8
PX-3517049600	CT Angiography Head W/Contrast/Noncontrast	$4,360	$4,360	—	—	8
PX-3517049200	CT Soft Tissue Neck W/O & W/Contrast Material	$4,282	$4,282	—	—	8
PX-3527127000	Diagnostic Computed Tomography Thorax C-/C+	$4,175	$4,175	—	—	8

Showing top 50 of 3,965 priced procedures, sorted by gross charge.

Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.